Depending on the phase of CML that has been diagnosed, treatment options include:
In recent years, new drugs that target specific parts of cancer cells have become standard treatment for people with early stage CML. Among these is imatinib, which is commercially known as Gleevec. It specifically targets and inhibits the BCR-ABL protein. Almost all patients respond well to treatment with Gleevec, with most responses lasting for many years. Additional drugs that target the BCR-ABL protein include dasatinib and nilotinib.
Chemotherapy, consisting of anti-cancer drugs taken by mouth or injection, is no longer the main treatment for CML. Its main role at this time is as part of the treatment during a blood and marrow transplant (BMT). It may also be used by itself later in the course of disease if other treatments have stopped working.
Blood and Marrow Transplant (BMT)
Blood and bone marrow transplantation (BMT) is a treatment option for CLL patients. The two primary types of BMT are autologous (using your own previously harvested cells) and allogeneic (using cells from a donor). Both are preceded by high-dose chemotherapy and/or radiation, which destroy not only the cancerous cells in your body, but healthy cells as well. You will be in the hospital during this time, to ensure that you are not exposed to possible infection. Then, during the transplant procedure, you’ll receive healthy donor cells which make their way to your bone marrow and start producing new blood cells.
Radiation therapy, treatment with high-energy rays to destroy cancer cells, is not usually part of the main treatment for CML patients. If, however, you have swollen internal organs (such as an enlarged spleen), radiation therapy may be used to reduce the number of cancer cells and shrink the organ.
Splenectomy is surgical removal of the spleen, which is infrequently done and usually chosen to reduce symptoms from an enlarged spleen such as pain and extreme pressure.